Differential Diagnosis for Burning in the Center of the Chest
Single Most Likely Diagnosis
- Gastroesophageal Reflux Disease (GERD): This is the most common cause of burning chest pain, often related to acid reflux and regurgitation. It's frequently associated with eating, lying down, or bending over.
Other Likely Diagnoses
- Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause burning chest pain, especially if they erode into the surrounding tissues.
- Esophagitis: Inflammation of the esophagus, often due to acid reflux, can cause burning pain in the chest.
- Musculoskeletal Pain: Strained muscles or costochondritis (inflammation of the cartilage that connects the ribs to the breastbone) can cause chest pain that feels like burning.
Do Not Miss Diagnoses
- Myocardial Infarction (Heart Attack): Although less common, a heart attack can present with burning chest pain, especially in women or diabetic patients. It's crucial to consider this diagnosis due to its high mortality rate if missed.
- Pulmonary Embolism: A blood clot in the lungs can cause sudden, severe chest pain that may feel like burning, along with shortness of breath and cough.
- Aortic Dissection: A tear in the aorta's inner layer can cause severe, tearing chest pain that may be described as burning, often radiating to the back.
Rare Diagnoses
- Esophageal Spasm: Abnormal muscle contractions in the esophagus can cause chest pain that feels like burning.
- Nutcracker Esophagus: A condition where the esophagus's muscle contractions are very powerful, causing chest pain and difficulty swallowing.
- Pericarditis: Inflammation of the sac surrounding the heart can cause sharp, burning chest pain that may improve with sitting up and leaning forward.